C17 Flashcards

1
Q

Gylycopeptides (3)

A

Teicoplanin
Oritavacin
Vancomycin

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2
Q

Glycopeptides MOA

A
  • Bactericidal glycoprotein
  • Bind to d-Ala-d-Ala terminal of peptidoglycan –> inhibit transglycosylation –> prevent elongation of the peptidoglycan chain and interferes with cross-linking.
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3
Q

Glycopeptide resistance development

give examples

A
  • bacterial replacement of the terminal d-Ala by d-lactate –> vancomycin binding site affinity is decreased
  • VRE and VRSA
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4
Q

Glycopeptides indications

A
  • Narrow spectrum
  • used for serious infections by G+’s (ex.MRSA)
  • used in combination with 3rd Gen. Cephalo. (ex. Ceftriaxon) against PRSP
  • used against C.difficile
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5
Q

Glycopeptides Pharmacokinetics

A
  • when given orally not absorbed by the G.I.
  • when given parenterally –> penetrates most tissues
  • eliminated unchanged in the urine
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6
Q

Glycopeptides administration

A
  • Orally (bacterial enterocolitis)

- Parenterally

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7
Q

Glycopeptides side effects

A
  • chills
  • Fever
  • Phlebitis
  • ototoxicity
  • Nephrotoxicity
  • Red Man Synd.
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8
Q

What is red man synd?

A

diffuse flushing as a result of histamine release after RAPID glycopeptides I.V. infusion

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9
Q

Lipopeptides AB example

A

Daptomycin

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10
Q

Daptomycin spectrum

A
  • similar to vancomycin

- but also active against vancomycin-resistant strains of enterococci and staphylococci

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11
Q

Daptomycin MOA

A

The drug inserts into the cytoplasmic membrane –> K+ leak –> cell death

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12
Q

Daptomycin pharmacokinetix

A

Daptomycin is eliminated via the kidney

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13
Q

Daptomycin SE

A
  • Daptomycin may cause myopathy

Creatine phosphokinase should be monitored

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14
Q

Peptide AB example

A

Bacitracin

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15
Q

Bacitracin MOA

A

interferes with a late stage in cell wall synthesis in G+’s

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16
Q

Bacitracin administration and SE

A
  • marked nephrotoxicity

- it is limited to topical use (because of the kidney)

17
Q

What about Mupirocin ?

A
  • it is a natural product from Pseudomonas Fluorescens
  • It acts on G+ cocci
  • Binds to isoleucyl-tRNA synthetase –> inhibits protein synthesis
18
Q

Mupirucin Pharmacokinetix and clinical use

A
  • when used topically (it is not absorbed):
  • staphylococcal impetigo
  • beta-hemolytic streptococci
  • Strep. pyogenes
  • when used intraNasally:
  • eliminate staphylococcal carriage by patients and medical personnel
19
Q

Mupirucin Toxicity?

A
  • Local itching
  • burning sensations
  • rash
  • erythema
  • contact dermatitis.